Another Type Of Congenital Heart Disease May Be Cured By The Device And The Surgery
17/12/2013 03:51
Another Type Of Congenital Heart Disease May Be Cured By The Device And The Surgery.
A congenital soul mistake that was typically harmful three decades ago is no longer so deadly, thanks to new technologies and surgical techniques that stand babies to survive well into adulthood, researchers report. A study in the May 27 problem of the New England Journal of Medicine compares the effectiveness of older and newer versions of devices aimed at fixing incompletely formed hearts. The over finds both performing equally well over three years.
It's a "landmark" study, "one that we've never had before in congenital verve disease," said Dr Gail D Pearson, skipper of the Adult and Pediatric Cardiac Research Program at the US National Heart, Lung and Blood Institute, which financed the effort. The study, which compared two devices for keeping oxygen-carrying blood flowing in 549 children born with hearts incapable of doing it alone, has not yet produced final results favoring one slogan over the other.
But the inquire into is in actuality just beginning. "Continuing follow-up will help us sort out the near- and long-term results," Pearson said. Study maker Dr Richard G Ohye, pate of the University of Michigan pediatric cardiovascular surgery division, agreed. "Well be able to follow them to adulthood, and they will enlighten us about the best way to manage them," he said. The children in the study were born with hearts that had a nonfunctioning - or nonexistent - radical ventricle, the chamber that pumps blood to the body. About 1000 such children are born in the United States each year, one in 5000.
Classically, they were damned for quick death. But about 30 years ago, Dr William Norwood of the Boston Children's Hospital developed a operation in which a shunt is implanted so that blood can gurgle from the heart to the lungs, where it picks up enough oxygen to approve life. That Norwood procedure, as it is called, is followed by a second operation at 4 to 6 months and a third at 18 to 36 months. If all else fails, a guts transplant can be done.
The strange study tested the older shunt, which connects the aorta, the main heart artery, to the lungs pulmonary artery, with a newer nonsuch that goes from the heart's right ventricle to the pulmonary artery. The newer shunt provides better results in the principal 1 year - 74 percent survival without a goodness transplant, compared to 64 percent with the older model. But there are more complications with the newer model, and the results are about the same with both shunts after 33 months of use, according to initial data.
So, the version continues. "We're continuing to follow these children until they are at least 6 and probably longer," Pearson said. "We'll be culture a lot more information over time". Even without functioning left ventricles, "many of these individuals conclude well into adulthood, including middle age," Pearson said. "Some can tangible what we think of as normal lives, participating in sports. Others may have more problems. Many have near-normal train tolerance and do most of the things children do," Ohye said.
But they do remain at risk of neurological problems, "because of the things they go through and natural issues," he said. For that reason, the neurological development of the children in the bookwork is being monitored, Pearson said, and a report on their mental progress will be issued in time. Whatever the results, "we have ushered in a experimental era," Ohye said provillusshop com. "This is the first randomized whack in congenital heart surgery".
A congenital soul mistake that was typically harmful three decades ago is no longer so deadly, thanks to new technologies and surgical techniques that stand babies to survive well into adulthood, researchers report. A study in the May 27 problem of the New England Journal of Medicine compares the effectiveness of older and newer versions of devices aimed at fixing incompletely formed hearts. The over finds both performing equally well over three years.
It's a "landmark" study, "one that we've never had before in congenital verve disease," said Dr Gail D Pearson, skipper of the Adult and Pediatric Cardiac Research Program at the US National Heart, Lung and Blood Institute, which financed the effort. The study, which compared two devices for keeping oxygen-carrying blood flowing in 549 children born with hearts incapable of doing it alone, has not yet produced final results favoring one slogan over the other.
But the inquire into is in actuality just beginning. "Continuing follow-up will help us sort out the near- and long-term results," Pearson said. Study maker Dr Richard G Ohye, pate of the University of Michigan pediatric cardiovascular surgery division, agreed. "Well be able to follow them to adulthood, and they will enlighten us about the best way to manage them," he said. The children in the study were born with hearts that had a nonfunctioning - or nonexistent - radical ventricle, the chamber that pumps blood to the body. About 1000 such children are born in the United States each year, one in 5000.
Classically, they were damned for quick death. But about 30 years ago, Dr William Norwood of the Boston Children's Hospital developed a operation in which a shunt is implanted so that blood can gurgle from the heart to the lungs, where it picks up enough oxygen to approve life. That Norwood procedure, as it is called, is followed by a second operation at 4 to 6 months and a third at 18 to 36 months. If all else fails, a guts transplant can be done.
The strange study tested the older shunt, which connects the aorta, the main heart artery, to the lungs pulmonary artery, with a newer nonsuch that goes from the heart's right ventricle to the pulmonary artery. The newer shunt provides better results in the principal 1 year - 74 percent survival without a goodness transplant, compared to 64 percent with the older model. But there are more complications with the newer model, and the results are about the same with both shunts after 33 months of use, according to initial data.
So, the version continues. "We're continuing to follow these children until they are at least 6 and probably longer," Pearson said. "We'll be culture a lot more information over time". Even without functioning left ventricles, "many of these individuals conclude well into adulthood, including middle age," Pearson said. "Some can tangible what we think of as normal lives, participating in sports. Others may have more problems. Many have near-normal train tolerance and do most of the things children do," Ohye said.
But they do remain at risk of neurological problems, "because of the things they go through and natural issues," he said. For that reason, the neurological development of the children in the bookwork is being monitored, Pearson said, and a report on their mental progress will be issued in time. Whatever the results, "we have ushered in a experimental era," Ohye said provillusshop com. "This is the first randomized whack in congenital heart surgery".